Hygiene monitoring system

ABSTRACT

A system and method is provided for monitoring hygiene compliance.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.14/049,308, filed Oct. 9, 2013, now U.S. Pat. No. ______, which is acontinuation of U.S. application Ser. No. 13/734,328, filed Jan. 4,2013, now U.S. Pat. No. 8,598,996, which is a continuation of U.S.application Ser. No. 12/901,891, filed Oct. 11, 2010, now U.S. Pat. No.8,368,544, which is continuation of U.S. application Ser. No.12/185,556, filed Aug. 4, 2008, now U.S. Pat. No. 7,812,730, which is acontinuation of U.S. application Ser. No. 11/339,378, filed Jan. 25,2006, now U.S. Pat. No. 7,408,470, which is a continuation of U.S.application Ser. No. 10/698,652, filed Oct. 31, 2003, now U.S. Pat. No.7,015,816, which is a continuation of U.S. patent application Ser. No.09/699,796, filed Oct. 30, 2000, now U.S. Pat. No. 6,727,818, whichclaims the benefit of U.S. Provisional Application No. 60/162,537, filedOct. 29, 1999, and claims the benefit of U.S. Provisional ApplicationNo. 60/169,315, filed Dec. 7, 1999, and claims the benefit of U.S.Provisional Application No. 60/223,365, filed Aug. 7, 2000; and all ofthe foregoing patents and patent applications are hereby incorporatedherein by reference in their entirety.

TECHNICAL FIELD

The present invention relates to a system for monitoring compliance withhygiene policies.

BACKGROUND

Systems to promote hygiene have been used in the healthcare industriesas well as the food processing and preparation industries. See forexample, U.S. Pat. No. 6,125,482, U.S. Pat. No. 6,038,331, U.S. Pat. No.5,966,573, U.S. Pat. No. 5,952,924, U.S. Pat. No. 5,954,069, U.S. Pat.No. 5,945,910, U.S. Pat. No. 5,939,974, U.S. Pat. No. 5,900,801, U.S.Pat. No. 5,812,059, U.S. Pat. No. 5,793,653, U.S. Pat. No. 5,781,942,U.S. Pat. No. 5,610,589, U.S. Pat. No. 5,202,666, and U.S. Pat. No.5,199,118.

SUMMARY

Hygiene monitoring systems, which incorporate various features of thepresent invention, monitor location of persons in a facility, locationof equipment in the facility, activities performed by persons in thefacility, activities performed by equipment in the facility, and/oractivities performed on equipment in the facility. From such gatheredinformation, the hygiene monitoring systems determine whether certainactions (e.g. washing of a person's hands, washing of a piece ofequipment) need to take place in order to comply with a hygiene policydefined for the facility. The hygiene monitoring systems may evaluatelevel of compliance with the hygiene policy, and provide persons withinformation (e.g. alerts, reminders, etc.) which aid in increasing thelevel of compliance with the hygiene policy.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a block diagram of a hygiene monitoring system whichincorporates various features of the present invention therein;

FIG. 2 shows a caregiver wearing a badge interacting with a handwashingdevice of the hygiene monitoring system;

FIG. 3 shows a patient room and exemplary alarm units of the exemplaryhygiene monitoring system;

FIG. 4 shows an exemplary hygiene compliance report being displayed byan exemplary master station of the exemplary hygiene monitoring system;

FIG. 5 shows a pictorial representation of a multi-zonal patient room;

FIG. 6 shows a flowchart representation of first handwashing logic usedby the hygiene monitoring system;

FIG. 7 shows an exemplary path that a caregiver may take through afacility over a period of time;

FIG. 8 is presented as FIG. 8 a and FIG. 8 b that together show aflowchart representation of second handwashing logic which may be usedby the hygiene monitoring system;

FIG. 9 shows a flowchart representation of equipment decontaminationlogic which may be used by the hygiene monitoring system;

FIG. 10 shows a sample hospital summary compliance report;

FIG. 11 shows a sample department summary compliance report;

FIG. 12 shows a sample group summary compliance report;

FIG. 13A shows a sample individual summary compliance report;

FIG. 13B shows a sample individual detailed compliance report; and

FIG. 14 shows an exemplary user interface of the hygiene monitoringsystem.

DETAILED DESCRIPTION

While the invention is susceptible to various modifications andalternative forms, exemplary embodiments thereof have been shown by wayof example in the drawings and will herein be described in detail. Itshould be understood, however, that there is no intent to limit theinvention to the particular forms disclosed, but on the contrary, theintention is to cover all modifications, equivalents, and alternativesfalling within the spirit and scope of the invention as defined by theappended claims.

Hygiene Monitoring System Architecture

FIGS. 1-4 illustrate an exemplary hygiene monitoring system 100 whichincorporates various features of the present invention therein. Ingeneral, the hygiene monitoring system 100 is operable to monitorcompliance with a particular hygiene policy defined for a facility. Tothis end, the exemplary hygiene monitoring system 100 includeshandwashing devices 101, sensors 108 associated with the handwashingdevices 101, caregiver badges 112, equipment badges 113 for monitoringequipment 115, alert indicators 116, sensors 118 operable to communicatewith caregiver badges 112 and equipment badges 113, usage sensors 119associated with monitored equipment 115, cleaning sensors 121 associatedwith monitored equipment 115, and a master station 129.

The master station 129 includes memory 125, a processing unit 126 andsoftware stored in the memory 125. The software when executed by theprocessing unit 126 generally causes the master station 129 to monitorpersons and equipment within the facility to monitor compliance with ahygiene policy defined for the facility. More specifically the masterstation 129 is operable to generate a compliance report 128 based uponthe processing of data by the central processing unit 126. Examples ofcompliance reports are shown in FIGS. 4, 10-12, 13A, 13B, and 14.Further, the master station 129 may be hardwired to the sensors 108,118, 119, 121 in order to receive and/or transmit informationtherebetween. Alternatively, the master station 129 may communicatewirelessly with the sensors 108, 118, 119, 121.

The caregiver badges 112 are generally worn by persons to be monitoredsuch as caregiver 110 shown in FIG. 2. The caregiver badges 112 aregenerally operable to communication identification information to thesensors 108, 118. Accordingly, the badges 112 and the sensors 108, 118generally each include a receiver, a transmitter, a combinationtransmitter and receiver, a transceiver, or other receiving ortransmitting mechanisms suitable for communicating identificationinformation between the badges 112 and the sensors 108, 118.

For example, each badge 112 of the exemplary embodiment includes aninfrared (IR) transmitter which transmits an identification signal 109,which may include, for example an identification code specific to theperson wearing the badge 112. Further, each sensor 108, 118 of theexemplary embodiment includes a receiver operable to receive theidentification signals 109 transmitted by badges 112. Further, eachsensor 108, 118 is operable to forward the information received to themaster station 129. In this manner, the location of each caregiver 110wearing a badge 112 may be tracked as the caregiver 110 moves throughoutthe facility. Besides providing the master station 129 withidentification information about the caregiver 110, functions (e.g.deactivating a nurse call light) may be triggered upon reception of theidentification signal by a sensor 118 associated with the function (e.g.a sensor in the patient room associated with the nurse call light).

In an exemplary embodiment, each badge 112 includes an IR transmitter.The IR transmitter transmits the identification signal 109 to masterstation 129 via the sensors 108, 118. For example, as diagrammaticallyillustrated in FIG. 2, the IR transmitter of a badge 112 transmits theidentification signal 109 to an IR receiver of a sensor 108 mountedabove a handwashing device such as sink 102. The sensor 108 thenprovides the information received via the identification signal 109 tothe master station 129 for further processing and recording.

Each badge 112 may further include an RF transmitter which alsotransmits the identification signal 109 to the master station 129. Theadvantage of transmitting using both the IR and RF transmitters is thatif the IR transmitter becomes obscured the RF signal should still bedetectable. The RF transmitter may also be used to transmit an alertsignal in response to the pressing of a button on the badge 112.

Each badge 112 may further include an RF receiver that is operable toreceive a signal, such as handwash signal 184 in FIG. 5, from the masterstation 129, wherein the signal includes the identification informationfor the badge 112 and status information about the caregiver 110 wearingthe badge 112. The status information relates to the caregiver'scompliance with the handwashing standards. Dependent upon the type ofstatus received, the badge 112 is operable to activate either a visual,audible or tactile alert indicator 116.

In one embodiment of the hygiene monitoring system 100, visitors andpatients are also provided with badges 112 so that their movementsthroughout the facility may be monitored. In such an embodiment,visitors and patients are given active badges which actively transmit anidentification signal. In an alternative embodiment, visitors andpatients are given passive badges which transmit an identificationsignal when polled by anyone of a plurality of transmitters locatedthroughout the facility. The advantage of the passive badges are thatthey are relatively inexpensive and have a limited read range(approximately nine feet). The limited read range of the passive badgesallows the location of the visitors and patients (or other objects) tobe tracked more closely. By providing badges 112 to visitors the systemis able to track the exposure each visitor and hence the patient's theycome in contact with has had with other contamination zones.Additionally, providing badges 112 to the patients allows the system totrack the exposure each patient has with other contamination zoneswithin the facility as the patient moves about the facility.

The equipment badges 113 are generally attached to equipment 115 (e.g.IV pumps, ventilators, carts, diagnostic equipment, or the like) to bemonitored by the hygiene monitoring system 100 and generally enable thelocation of equipment 115 to be tracked throughout the facility. Theequipment badges 113 are generally operable to communicateidentification information to the sensors 118. Accordingly, the badges113 and the sensors 118 generally each include a receiver, atransmitter, a combination transmitter and receiver, a transceiver, orother receiving or transmitting mechanisms suitable for communicatingidentification information between the badges 113 and the sensors 118.As a result of providing the hygiene monitoring system 100 withinformation concerning the location of equipment 115, the hygienemonitoring system 100 may further base determinations of hygienecompliance based upon the location of the equipment 115 and/or persons'interactions with such equipment 115.

The usage sensors 119 are generally associated with equipment 115 in thefacility and generally enable the hygiene monitoring system 100 tomonitor the use of such equipment 115. For example, the usage sensors119 may be attached to the electrical plug of the equipment 115 todetermine whether the equipment 115 is drawing a current. Further, theusage sensors 119 may be included in the equipment badge 113 or beseparate from the equipment badge 113 attached to the equipment 115. Theusage sensors 119 enable the hygiene monitoring system 100 to basedeterminations of hygiene compliance upon actual use of equipment 115.Furthermore, by reporting when the equipment 115 is activated andde-activated, the usage sensors 119 enable the hospital to chargepatients for the actual amount of time the equipment 115 was usedinstead of utilizing national averages based on the type of illness ofthe patient.

Likewise, the cleaning sensors 121 are generally associated withequipment 115 in the facility and generally enable the hygienemonitoring system 100 to monitor cleaning of such equipment 115 byproviding the hygiene monitoring system 100 with information associatedwith the cleaning of the equipment 115. For example, the cleaningsensors 121 may be implemented as a switch or button which whenactivated provides the master station 129 with information indicatingthat there as been an attempt to clean the equipment 115. Alternatively,the cleaning sensors 121 may be implemented to detect moisture and/orphysical contact associated with the cleaning process. In an exemplaryembodiment, the master station 129 and/or the cleaning sensor 121further ensures that adequate cleaning of the equipment 115 has beenperformed by requiring that the person cleaning the equipment 115 be inthe proximity of the equipment 115 for a minimum amount of time and/ormoisture associated with the cleaning process be detected for theminimum amount of time and/or physical contact associated with thecleaning process be detected for the minimum amount of time.

The equipment badges 113 may be implemented in the same manner as thecaregiver badges 112. Alternatively, the equipment badges 113 may beimplemented with general active badges which actively transmit a signalincluding the state of the associated usage sensor 119, the state of theassociated cleaning sensor 121 and identification information associatedwith the equipment 115. As yet another alternative, the equipment badges113 may be implemented as passive badges which transmit a signalincluding the state of the associated usage sensor 119, the state of theassociated cleaning sensor 121 and the identification information forthe equipment 115 when polled by the hygiene monitoring system 100. Tosupport the passive badge embodiment, the hygiene monitoring system 100may include transmitters in the patient room to poll the passive badges.The transmitters, in one embodiment, further include an associatedsensor to detect the signals transmitted by the badges.

The badges 112, 113 and sensor 108, 118 may further utilizeanti-collision technology which allows for information to be transferredbetween a single sensor 108, 118 and multiple badges 112, 113 in asimultaneous or pseudo-simultaneous (e.g. TDMA, CDMA) manner. Anycommercially available anti-collision technology may be used. Use ofthis technology allows for several badges 112, 113 to be detected at thesame time by the same sensor 108, 118 thereby providing the hygienemonitoring system 100 with the ability to identify caregivers andequipment 115 in close proximity to one another and accurately tracktheir respective hygiene status. Thus, when a team of doctors and nursesis caring for a patient, the hygiene monitoring system 100 is able toidentify the individual persons within the group of caregivers andmonitor their hygiene status. Likewise, the hygiene monitoring system100 is operable to determine individual persons of a group of persons infront of a particular handwashing device 101 during a handwashing.

Additional details concerning the structure and function of a suitablesystem for locating and tracking persons and which may be utilized tosupport various other features of the present invention are disclosed inU.S. Pat. No. 5,561,412, the disclosure of which is hereby incorporatedby reference. Another location and tracking system is disclosed in U.S.Pat. No. 6,344,794 which is hereby incorporated by reference. Additionallocation and tracking systems are disclosed in U.S. Pat. Nos. 4,275,385;4,601,064; Re 35,035; 5,633,742; 5,745,272; 5,818,617; 5,119,104;5,387,993; 5,548,637; 5,572,195; 5,291,399; 5,455,851; 5,465,082;5,515,426; 5,594,786; 5,689,229; 5,822,418; 5,822,544; 5,699,038 and5,838,223.

Shown in FIG. 2 is an exemplary sink 102 which may be used to implementthe handwashing devices 101 of the present invention. As shown in FIG.2, the exemplary sink 102 includes a “hand free” faucet 104 having an IRsensor and a faucet monitoring device 106. However, it is within thescope of the present invention to include a faucet 104 which is not“hands free” and a separate IR sensor or an IR sensor that is activatedupon activation of the faucet 104. Water is dispensed from faucet 104when the presence of the caregiver's hands 107 are detected by faucetmonitoring device 106 or when the caregiver otherwise activates faucet104. The IR sensor of the “hands free” faucet 104 senses the heat (IRenergy) radiated from caregiver hands 107. The sensed heat is anindication to faucet monitoring device 106 that hands 107 are positionedbelow the faucet and are ready to be wetted. Upon activation of faucet104 a washing compliance signal is generated and forwarded to masterstation 129 by faucet monitoring device 106.

Alternatively, the faucet monitoring device 106 may include aphotosensor or other type of non-contact sensor. Additionally, a sensormay be mounted within faucet 104 to determine when water is expelledfrom faucet 104. Yet another alternative faucet monitoring device 106includes a sensor 120 on a soap dispenser 121 to monitor the usage ofsoap during the handwashing. Faucet monitoring device 106 could includemultiple sensors such as an IR sensor to sense the presence of hands 107and a soap dispenser sensor 120 to detect the usage of soap duringwashing.

The compliance signal generated by faucet monitoring device 106 and theidentification signal received by sensor 108 combine to provideinformation about the identity of caregiver 110 in front of sink 102 andwhether or not caregiver 110 washed his/her hands 107. Both signals aregenerated and recorded without any input required from caregiver 110. Inthe exemplary embodiment, the compliance signal is generated over eleveninput lines which connect faucet monitoring device 106 with sensor 108,one line for each bit. The first eight bits communicate data from thefaucet monitoring device 106 to sensor 108 while the last three bitscommunicate data from sensor 108 to faucet monitoring device 106. Bit 1is used as a fault bit. A “0” value indicates that the faucet isoperating properly while a “1” value indicates that the faucet is notoperating properly. Bits 2 and 3 are handwashing status bits. Thecombination of bits 2 and 3 have the following states: “00” nohandwashing procedure in progress, “10” handwashing procedure inprogress, “11” successful handwashing procedure, and “01” failedhandwashing procedure. Bits 4-8 provide an indication as to themaintenance status of the various components related to faucetmonitoring device 106, such as faucet 104 and soap dispenser 121. A “1”value for bit 4 indicates that the soap container is low, a “1” valuefor bit 5 indicates that the soap caseate needs to be changed, a “1”value for bit 6 indicates that the soap path needs to be changed, and a“1” value for bit 7 indicates that the towel container is low. It iswithin the scope the invention to monitor various other parameters inplace of or in addition to the ones listed above.

Bits 9-11 are used as input to faucet monitoring device 106 from sensor108. Bit 9 is used as a badge presence indicator. In one embodiment, bit9 provides a “1” value when an identification signal 109 is detected bysensor 108. In another embodiment, bit 9 provides a “0” value whensensor 108 is receiving an identification signal 109 from a contaminatedcaregiver 110 and a “1” value when sensor 108 is receiving anidentification signal 109 from a non-contaminated caregiver 110 or noidentification signal is being received. Bit 10 is used to communicatewhether sensor 108 is functioning properly and if sensor 108 is able tocommunicate with master station 129. Bit 11 is used to send a message tofaucet monitoring device 106 to start a self test procedure. In oneembodiment, faucet monitoring device begins monitoring for complianceonly when the presence of hands 107 are detected and bit 9 from sensor108 indicates that an identification signal has been detected.

When a caregiver 110 is positioned in front of sink 102, sensor 108detects identification signal 109 transmitted by badge 112 as showndiagrammatically in FIG. 2. Sensor 108 is mounted above sink 102 andincludes an IR receiver connected to the hygiene monitoring system 100.The received identification signal is forwarded onto master station 129and recorded. It is within the scope of the present invention aspresently perceived to use a RF, ultrasonic or other suitable system fordetecting the presence of a caregiver in contamination zones, patientrooms, or by sink 102. Alternative devices can be used for sensor 108such as a radio receiver if badge 112 transmitted a radio signal insteadof an infrared signal.

Sensor 108 combines the compliance signal from faucet monitoring device106, bits 1-8, and the received identification signal 109. The combinedsignal or packet is transmitted to or made available to or detected bymaster station 129. In a preferred embodiment, sensor 108 includes aradio frequency transmitter to transmit a radio frequency transmissionto master station 129. In one embodiment the combined signal or packetconsists of 35 bits. Bits 1 and 2 are start bits. Bits 3-10 are aportion of identification signal 109, the LO Byte of the caregiver ID.Bit 11 is a parity bit for use as an error check for bits 3-10. Bits12-19 are a portion of identification signal 109, the HI Byte of thecaregiver ID. Bit 20 is a parity bit for use as an error check of bits12-19. Bits 21-28 are the eight bits sent to sensor 108 from faucetmonitoring device 106. Bit 29 is a parity bit for use as an error checkfor bits 21-28. Bits 30-33 are extra bits for expansion use, such as tocommunicate the status of various pieces of equipment, lights, IV pumps,etc. Bit 34 is a parity bit for use as an error check for bits 30-33.Bit 35 is a stop bit.

Besides sinks 102, the handwashing devices 101 as depicted in FIG. 5 mayalso be implemented with automatic alcohol dispenser 210, dispensers250, or other monitored devices with which a person may successfullywash her hands in accord with a hygiene policy. In some environments, itis permissible for caregiver 110 to cleanse hands 107 with an alcoholtowelette dispensed by alcohol dispenser 210, as opposed to washing herhands in front of a sink with soap and water. Therefore, in oneembodiment of the hygiene monitoring system 100, the hygiene monitoringsystem 100 further tracks whether persons wash their hands with analcohol towelette that is dispensed from the automated alcohol dispenser210 and updates compliancy information based upon such determinations.To this end, the hygiene monitoring system 100 utilizes a sensor such assensor 108C proximate with the alcohol dispenser 210 to determinewhether the person has washed her hands via the alcohol dispenser 210.

In some environments, it is also permissible for caregiver 110 tocleanse hands 107 with a waterless hand sanitizer such as an alcoholbased gel dispensed from dispenser 250. An exemplary dispenser 250 isthe “Bag-in-a-Box Dispenser” which receives a bladder filled with handsanitizer. Dispenser 250 further includes a sensor 108 to detectidentification signal 109 transmitted by badge 112. Sensor 108 eitherdetects signal 109 and then waits to sense a dispensing of handsanitizer or is activated upon the detection of hand sanitizer beingdispensed from dispenser 250. Therefore, in one embodiment of thehygiene monitoring system 100, the hygiene monitoring system 100 furthertracks whether persons wash their hands with hand sanitizer dispensedfrom dispenser 250 and updates compliancy information based upon suchdeterminations.

In a further embodiment, the dispenser 250 is implemented as a portabledispenser, similar to a pump bottle or squeeze bottle, which is carriedby caregiver 110. Portable dispenser 250 includes a sensor to detectwhen sanitizer is dispensed from dispenser 250. An example sensor wouldbe a sensor to detect the movement of the stem of a hand pump on a pumpbottle or the movement of sanitizer through an orifice. The use ofportable dispenser 250, which is small enough to fit in the caregiver'scoat or pocket, provides caregiver 110 with easy access to handsanitizer and does not require additional hardware such as sensors anddispensers to be mounted on the wall in various locations throughout thehospital.

Portable dispenser 250 either includes a transmitter such as equipmentbadge 113 or a combination transmitter and receiver. In one embodimentwherein only a transmitter is used, portable dispenser 250 is assignedto caregiver 110 such that the equipment badge 113 of the dispenser 250either transmits an identification signal which is identical to orincorporates a portion of caregiver identification signal 109 or anidentification signal which is associated with caregiver 110 in adatabase at master station 129. In another embodiment wherein both atransmitter and a receiver or a transceiver is associated with portabledispenser 250, portable dispenser 250 receives identification signal 109from caregiver badge 112. Portable dispenser 250 then forwards a signalsuch as the caregiver identification signal plus a compliance signalonto master station 129 either directly or through sensor 118.

Alert indicators 116 generally provide caregivers with feedbackconcerning their current contamination status and/or infraction status.In one embodiment, visual alert indicators 116 are included in theproximity of sinks 102, such as on faucet 104. The visual alertindicators 116 are capable of providing textual messages “eithercontinuously or at defined intervals and potentially other visual cuessuch as blinking diodes. The visual alert indicators 116 may providefeedback to caregiver 110 on whether a successful handwashing has beenaccomplished or not. The visual alert indicators 116 may also providemessages such as “HANDWASHING CONFIRMED” or “SUCCESSFUL” for a properlycompleted handwashing event. The visual alert indicators 116 may alsoprovide messages such as “WARNING HANDWASHING FAILED” or “FAILED” whencaregiver 110 has not completed a successful handwashing. Anunsuccessful handwashing would occur for example when caregiver 110 useswater but not soap. Further, the visual alert indicators 116 alsoprovides information about the maintenance state of the faucet, sink orother devices. Example messages include “SINK READY FOR USE”, “SELF-TESTIN PROGRESS”, “WARNING! SOAP CONTAINER LOW”, “WARNING! CHANGE SOAPCASSETTE”, “WARNING! CHANGE SOAP PATH”, or “WARNING! TOWEL CONTAINERLOW.”

The alert indicators 116 may also be placed in various locations in thepatient rooms such as on bed 122, on the wall of the patient's room, orincorporated into an overhead lighting fixture 114 as shown in FIG. 3.Such alert indicators 116 may be implemented to either remind caregiver110 to wash hands 107 or to indicate that a handwashing compliancesignal has been recorded. The timing for each type of indication isexplained below in more detail with reference to FIG. 6 and FIG. 8. Forexample, such an alert indicator 116 may include a set number of lightsor a single light which are covered by a colored semi-transparentshield. Various indications are given based on which lights in the setof lights are turned on and which lights in the set of lights are turnedoff or whether any of the lights in the set of lights are flashing. Inone embodiment, the light shield contains a graphic message such as“handwash verified” as shown in FIG. 3.

In embodiments where alert indicators 116 are located throughout afacility, the master station 129 may cause a signal to be directed to analert indicator that is in close proximity to the caregiver 110. Forexample, the master station 129 may provide a handwash signal to analert indicator 116 in the same room as the caregiver 110 when ahandwash condition exists for the caregiver 110. In such an embodiment,the alert indicators 116 may be either “wirelessly connected” or“hardwired” to the master station 129. Moreover, the alert indicator 116in such embodiments could be implemented as a bank of lights including alight corresponding to each person monitored, or it may be implementedwith remote units such as, for example, banks of lights or speakers thathave been mounted in various locations in the facility.

Alert indicators 116 may also be implemented in a portable manner. Forexample, alert indicators 116 may be incorporated into badges 112 orcarried by caregiver 110 as a separate unit, such as a pager-type unit.Such alert indicators 116 would include a sensor to receive handwashsignal 184 provided by the hygiene monitoring system 100. In oneembodiment, the portable alert indicators 116 include a radio frequencyreceiver to receive a signal from master station 129, sensor 108 orother sensors such as sensor 118. The received signal includes thecaregiver ID to distinguish between different caregivers 110 and aninfraction level code to communicate the status of the caregiver 110,either in compliance with the handwashing standards or out of compliancewith the handwashing standards.

The alert indicators 116 may be implemented to vary output based uponthe number of non-compliance data 140 which is recorded by system 100for caregiver 110. In one embodiment, lights are included on badge 112,such as light emitting diodes. When caregiver 110 is complying withhandwashing regulations the lights on badge 112 are off. When caregiver110 enters a contamination zone the lights or at least one of the lightsblinks yellow to indicate that caregiver 110 has entered a contaminationzone. If caregiver 110 violates the handwashing standards, i.e. anon-compliance

signal 140 is generated, the lights or at least one of the lights slowlyblinks red. If caregiver 110 does not wash hands 107 at this point andviolates the handwashing standards a second time the lights or at leastone of the lights blinks red at a faster rate. If caregiver 110 commitsa third consecutive infraction of the handwashing standards then thelights or at least one of the lights blinks red very fast. If thecaregiver 110 commits a fourth consecutive infraction of the handwashingstandards then the lights or at least one of the lights remains on andan alarm is sounded by an audible or tactile indicator on badge 112.

It is within the scope of the invention as presently perceived toimplement alert indicators 116 to include visual, audible and/or tactileindicators which respectively produce visual signals, audible signals,and tactile signals. An example of a visual indicator is a LED, anexample of an audible indicator is a speaker, and an example of atactile indicator is a vibration device similar to a pager vibrationdevice.

Multi-Zonal Patient Rooms

In FIG. 5 is shown an example of patient room 230 having generally fivedifferent zones. An entry zone 220, a clinical zone 222, a patient zone224, a family zone 226 and a hygiene zone 228. All of these zones exceptfor the family zone 226 has a sensor 118 associated therewith. As shownin FIG. 5, caregiver 110 enters patient room 230 through the entry zone220. As the caregiver enters the entry zone 220, the identificationsignal 109 broadcasted by caregiver badge 112 is detected by sensor118A. If caregiver 110 proceeds to the patient zone 224, then the signalbroadcasted by the caregiver badge 112 is detected by sensor 118C.Patient zone 224 is a critical contamination zone. Therefore, thehygiene monitoring system 100 initiates the first handwashing monitoringlogic depicted in FIG. 6. Also shown in FIG. 5 are various handwashingdevices 101 such as two sinks 102A and 102B each containing a sensor108A and 108B, respectively, an automated alcohol dispenser 210, and adispenser 250 of hand sanitizer.

In one embodiment, patient room 230 further includes a sensor 254.Unlike sensors 118A-118D which generally receive signals 109 whencaregiver 112 is within the corresponding zone 220, 222, 224 and 228,sensor 254 generally receives signal 109 when caregiver 112 is presentin patient room 230 independent of whether caregiver 112 is within oneof the zones 220, 222, 224 and 228 or elsewhere in patient room 230. Assuch, sensor 254 is a low resolution aspect of the hygiene monitoringsystem 100 while sensors 118A-118D are a high resolution aspect of thehygiene monitoring system 100. Sensor 254 is designed to be compatiblewith badge 112. Therefore, if badge 112 emits only an IR signal 109 thensensor 254 should be designed to receive an IR signal 109.Alternatively, if badge 112 emits both an IR signal 109 and a RF signal109 then sensor 254 should be designed to receive either IR signal 109,RF signal 109 or a combination of IR signal 109 and RF signal 109.

First Handwashing Logic

A flowchart is depicted in FIG. 6 which illustrates first handwashinglogic implemented by the hygiene monitoring system 100. In the exemplaryembodiment, the master station 129 includes software which when executedby the master station 129 causes the hygiene monitoring system 100 toimplement the first exemplary handwashing logic as depicted in FIG. 6.However, while the exemplary embodiment of the hygiene monitoring system100 implements the handwashing logic of FIG. 6 with software executed bythe master station 129, the handwashing logic of FIG. 6 mayalternatively be implemented with hardware incorporated in a centraldevice such as the master station 129 or distributed amongst the othercomponents of the hygiene monitoring system 100. Furthermore, thesoftware can be implemented as a stand alone program or can beintegrated into the software of an existing system for locating andtracking persons in a facility.

In an exemplary embodiment, the hygiene monitoring system 100 invokesexecution of the first handwashing logic as represented by block 130every time a caregiver identification signal 109 is detected in a nurseor patient contact zone, such as a patient room or nurse station. Thepresence of caregiver 110 in such a zone is determined by the hygienemonitoring system 100 upon the detection of identification signal 109.The hygiene monitoring system 100 determines, based on the previousrecorded locations of caregiver 110, if caregiver 110 has complied withhandwashing standards. Therefore, the hygiene monitoring system 100monitors for compliance based upon the occurrences of specific events.The hygiene monitoring system 100 also evaluates the time elapsedbetween handwashings to determine if a preset maximum time has beenexceeded. Therefore, the hygiene monitoring system 100 further monitorsfor compliance based upon frequency of handwashings.

Once execution of the first handwashing logic is initiated, the hygienemonitoring system 100 evaluates the previous location of caregiver 110as indicated by block 132. The current and previous locations ofcaregiver 110 are determined and stored by the hygiene monitoring system100 during the cause of operation. The elapsed time since the lastrecorded compliance data record is determined by the hygiene monitoringsystem 100, as indicated by block 133. The hygiene monitoring system 100next determines, as indicated by block 134, if a handwashing compliancesignal has been received in conjunction with the previous location ofcaregiver 110. A handwashing compliance signal is generated by faucetmonitoring device 106 or other handwashing device when caregiver 110washes hands 107 and is transmitted to or detected by master station129. If a handwashing compliance signal has been received, thecompliance data is recorded, as indicated by block 136. If a handwashingcompliance signal was not recorded, the hygiene monitoring system 100moves to block 138 which determines whether the previous location ofcaregiver 110 was a contamination zone.

A contamination zone is any area designated by the hospital where aftercaregivers have entered they must wash her hands. Typically, acontamination zone is an area in which caregiver 110 is susceptible tocontact with infectious agents. Examples are a patient room, a bathroom, a waste station or a nurse station. If the previous location ofcaregiver 110 was a designated contamination zone a handwashingnon-compliance data is recorded as indicated by block 140. Thenon-compliance data is recorded because caregiver 110 has left acontamination zone and entered a nurse or patient contact zone withoutwashing hands 107, thereby putting patients and colleagues at risk ofinfection.

If the previous location of caregiver 110 was not a contamination zoneat block 138, the hygiene monitoring system 100 continues to block 139and determines if the maximum time permitted between handwashings hasbeen exceeded. If the maximum time has been exceeded, then a handwashingnon-compliance record is recorded by block 140. If the previous locationof caregiver 110 was not a contamination zone and the maximum timepermitted between handwashings has not been exceeded, the hygienemonitoring system 100 returns to block 132 and evaluates the twiceprevious location of caregiver 110. If a handwashing compliance was notindicated for the twice previous location nor was the twice previouslocation a contamination zone, the hygiene monitoring system 100 returnsto block 132 and evaluates the thrice previous location of caregiver110, assuming that the maximum time permitted between handwashings hasnot been exceeded. The hygiene monitoring system 100 continues untileither a handwashing compliance record is recorded by block 136 or ahandwashing non-compliance record is recorded by block 140.

If a non-compliance data record is recorded by block 140, the hygienemonitoring system 100 generates a handwash alarm signal as representedby block 182. The hygiene monitoring system 100 then sends the handwashalarm signal to an alert indicator 116 of caregiver 110. The sensor onthe alert indicator 116 receives the alarm signal represented by block184, and the alert indicator 116 provides the caregiver 110 with analert signal, represented by block 186. Example alert signals includevisual signals, audible signals, tactile signals or combinationsthereof.

Referring now to FIG. 7, there is depicted a hospital ward 142 and asample path 144 taken by caregiver 110 through the hospital ward 142.The location of caregiver 110 is detected by sensor 118 a-118 d whencaregiver 110 is next to patient bed 150 a-150 d, respectively. Thelocation of caregiver 110 is detected by sensor 108 a-108 e whencaregiver 110 is near sinks 102 a-102 e, respectively. At otherlocations in hospital ward 142, the location of caregiver 110 isdetected by sensors 118 e-1180.

Caregiver 110 starts at nurse station 146 as indicated by position (A).Caregiver 110 next leaves nurse station 146 and enters a patient room148 a and approaches the patient bed 150 a, as indicated by position(B). Caregiver's badge transmits a signal which is detected by sensor118 a and read by master station 129 indicating that the caregiver is byposition (B), thereby initiating the hygiene monitoring system 100 tobegin execution of the handwashing monitoring logic because caregiver110 has entered a nurse or patient contact zone, near patient bed 150 a.The previous position (A) of caregiver 110 does not have a handwashingcompliance signal recorded and position (A) is a contamination zone.Therefore, a non-compliance data record is recorded at block 140.

Caregiver 110 next leaves position (B) without washing hands 107 at sink102 a and enters a second nurse or patient contact zone, patient room148 b next to patient bed 150 b, as indicated by position (D). Onceagain, the hygiene monitoring system 100 initiates execution of thefirst handwashing logic because caregiver 110 has entered a nurse orpatient contact zone, near patient bed 150 b. The previous position (C)of caregiver 110 does not have a handwashing compliance signal recorded.However, position (C), a hallway, is not a contamination zone. Afterdetermining that the maximum time permitted between handwashings has notbeen exceeded, the twice previous caregiver location, position (B) inpatient room 148 a near bed 150 a is evaluated. Position (B) does nothave a handwashing compliance signal recorded. However position (B) is acontamination zone. Therefore, a non-compliance data record is recordedat block 140.

Caregiver 110 next enters bathroom 154 b, at position (E) and thenwashes hands 107 at sink 102 b, position (F). Therefore, a handwashingcompliance signal is generated by faucet monitoring device 106 b.

Caregiver 110 next enters a third nurse or patient contact zone atposition (H), patient room 148 c. Once again, the hygiene monitoringsystem 100 initiates execution of the first handwashing logic becausecaregiver 110 has entered a nurse or patient contact zone. The previousposition (G) of caregiver 110 does not have a handwashing compliancesignal recorded. However, position (G), a hallway, is not acontamination zone. After determining that the maximum time permittedbetween handwashings has not been exceeded, the twice previous caregiverlocation, position (F) in patient room 148 b near sink 102 b istherefore evaluated. Position (F) does have a handwashing compliancesignal recorded. Therefore, a compliance data record is recorded atblock 136.

Caregiver 110 continues on to position (J), a waste station 158, whichis a contamination zone. Next, caregiver 110 washes hands at position(K), sink 102 e. Therefore, a handwashing compliance signal is generatedby faucet monitoring device 106 e. The fact that caregiver 110 did notwash hands 107 between locations (H) and (J) is acceptable, as long asthe maximum time permitted between handwashings has not been exceeded,because caregiver 110 did not enter a nurse or patient contact zonebetween locations (H) and (J).

Caregiver 110 continues on to position (M) a fourth nurse or patientcontact zone, patient room 148 d next to patient bed 150 d. Once again,the software is initiated by central processing unit 126 and begins itshandwashing monitoring logic. The previous position (L) of caregiver 110does not have a handwashing compliance signal recorded. However,position (L), the hallway, is not a contamination zone. Afterdetermining that the maximum time permitted between handwashings has notbeen exceeded, the twice previous caregiver location, position (K) nearsink 102 e is evaluated. Position (K) does have a handwashing compliancesignal recorded. Therefore, a compliance data record is recorded atblock 136.

Caregiver 110 continues on to nurse station 146, position (P). Sincecaregiver 110 is in a nurse contact zone at position (P), the hygienemonitoring system 100 initiates execution of the first handwashinglogic. The previous position (0) of caregiver 110 does not have ahandwashing compliance signal recorded. However, position (0), ahallway, is not a contamination zone. After determining that the maximumtime permitted between handwashings has not been exceeded, the twiceprevious caregiver location, position (N) in patient room 148 d near bed150 d is evaluated. Position (N) does not have a handwashing compliancesignal recorded. However position (N) is a contamination zone.Therefore, a non-compliance data record is recorded at block 140.

Caregiver 110 achieved a forty percent compliance rating, washed hands107 two out of five required times, for path 144, as shown in FIG. 7.Compliance report 128 provides the compliance rating of caregiver 110and provide information such as the time each compliance record wasrecorded, the time each non-compliance record was recorded, and thelocations of each, see FIG. 13B.

The above handwashing monitoring logic may further utilize a delay timerto prevent a brief encounter with a patient contact zone to require acaregiver to wash her hands. For example, upon detecting theidentification signal 109 from caregiver badge 112 within a patientzone, the hygiene monitoring system 100 will delay a preset amount oftime before starting the handwashing monitoring logic, such as 15seconds. If the identification signal 109 is still detected in thepatient contact zone after the present amount of time has expired, thenthe handwashing monitoring logic begins. Therefore, a caregiver simplydropping off a lunch tray will probably not invoke the handwashingmonitoring logic, while a caregiver who is interacting with a patientprobably will invoke the handwashing monitoring logic.

Second Handwashing Logic

Referring now to FIG. 8, there is illustrated a flowchart of secondexemplary handwashing logic which may be implemented by the hygienemonitoring system 100. The second exemplary handwashing logic of FIG. 8is essentially an alternative to the first exemplary handwashing logicof FIG. 6. In the exemplary embodiment, the master station 129 includessoftware which when executed by the master station 129 causes thehygiene monitoring system 100 to implement the second exemplaryhandwashing logic as depicted in FIG. 8. However, while the exemplaryembodiment of the hygiene monitoring system 100 implements thehandwashing logic of FIG. 8 with software executed by the master station129, the handwashing logic of FIG. 8 may alternatively be implementedwith hardware incorporated in a central device such as the masterstation 129 or distributed amongst the other components of the hygienemonitoring system 100. Furthermore, the software can be implemented as astand alone program or can be integrated into the software of anexisting system for locating and tracking persons in a facility.

In general, the master station 129 in accord with the alternativehandwashing logic of FIG. 8 determines whether various events haveoccurred based upon information (e.g. caregiver location, handwashinginformation) received from the various sensors of the hygiene monitoringsystem 100. Events are points in time at which some change in status maytake place. Typically, events are caused by movement of persons into orout of a zone, or the expiration of a time limit for a person in a givenzone, or by other mechanisms. In an exemplary embodiment, the masterstation 129 determines that a caregiver 110 has moved between two zoneswhen the badge 112 worn by the caregiver 110 is detected in the firstzone, the badge 112 is later detected in the second zone, and the badge112 ceases to be detected in the first zone.

In an exemplary embodiment, the master station 129 determines that acontrolled Handwash Event has occurred when a caregiver 110 wearing abadge 112 has successfully completed a handwashing at a monitoredhandwashing device such as sink 102. (See, steps 320, 328, and 332).Moreover, the master station 129 further updates a Contamination Statusassociated with the caregiver 110 to indicate that the caregiver 110 is“Not Contaminated” whenever the caregiver 110 wearing a badge 112 hascompleted a successful handwashing, updates and Infraction Statusassociated with the caregiver 110 to indicates that the caregiver 110 is“Compliant”, and if the caregiver was contaminated prior to thecontrolled Handwashing Event updates the compliance rating for thecaregiver. For example, a successful handwashing occurs when the badge112 worn by the caregiver 110 is detected by a sensor 108 associatedwith sink 102 for a duration greater than or equal to a preset amountfor a successful handwashing. It is within the scope of the invention torequire additional parameters to be satisfied for a handwashing to besuccessful, such as soap was dispensed, drying unit or towel wasdetected.

The master station 129 of the exemplary embodiment also determines thatan Exposure Event has occurred when a caregiver 110 wearing a badge 112has been in a contamination zone for longer than a Exposure Timeassociated with that contamination zone. The Exposure Time is the amountof time for a particular contamination zone, that a caregiver 110 canremain in a particular contamination zone without causing an ExposureEvent. (See, 314 and 316). However, the master station 129 may alsodetermine that an Exposure Event has occurred when the hygienemonitoring system 100 has not detected a caregiver 110 wearing a badge112 for more than an hour or some other preset amount of time. (See,steps 300 and 304). Further, the master station 129 may also determinethat an Exposure Event has occurred when the master station 129determines that more than thirty minutes or some other preset amount oftime has past since a controlled Handwashing Event has been associatedwith the caregiver 110 (i.e. the caregiver 110 has not successfullywashed her hands for more than some preset amount of time). (See, steps302 and 304).

In the exemplary embodiment, the Exposure Time is independently definedfor each contamination zone of the facility and is typically defined ata constant value for a particular contamination zone. However, theExposure Time for a particular contamination zone may alternatively bedefined based upon a particular caregiver or class of caregivers. Forexample, the Exposure Time for a particular contamination zone may bedefined to cause an Exposure Event for a first caregiver if the firstcaregiver remains in the contamination zone for ten seconds and cause anExposure Event for the second caregiver only if the second caregiverremains in the contamination zone for at least twenty seconds. Moreover,when determining how long a particular caregiver 110 has been exposed toa particular contamination zone, the master station 129 of the exemplaryembodiment considers a caregiver 110 to have been continuously exposedto the contamination zone if the badge 112 worn by the caregiver 110 iscontinuously detected in the same contamination zone, regardless ofwhether the same badge 112 is detected in other zones as well.

The Exit Time is a preset amount of time associated with a particularcontamination zone which defines an amount of time that a caregiver 110has to exit the particular contamination zone following a controlledHandwashing Event without being re-contaminated by the contaminationzone. In general, the Exit Time extends the length of time after acontrolled Handwashing Event that a caregiver 110 may remain in thecontamination zone without being re-contaminated by the contaminationzone. In other words, the master station 129 of the exemplary embodimentdetermines that an Exposure Event has occurred for a caregiver 110wearing a badge 112 when the caregiver 110 performs a successfulhandwashing at a monitored handwashing device within a contaminationzone and the caregiver 110 remains in the contamination zone for theduration of the greater between the Exposure Time and the Exit Time.(See, steps 318, 320, 322, and 316). In a high risk contamination zone(e.g. isolation room, waste utility room, public restroom) having anExposure Time of zero associated therewith, the Exit Time permits acaregiver 110 to perform a successful handwashing within the high riskcontamination zone and exit the high risk contamination zone within theExit Time without causing an Exposure Event despite the fact that theExposure Time had been exceeded.

Similar to the Exposure Time, the exemplary embodiment defines the ExitTime independently for each contamination zone of the facility andtypically defines the Exit Time at a constant value for a particularcontamination zone. However, the Exit Time for a particularcontamination zone may alternatively be defined based upon a particularcaregiver or class of caregivers. For example, the Exit Time for aparticular contamination zone may be defined such that the masterstation 129 determines that an Exposure Event has occurred for a firstcaregiver of a first class of caregivers (e.g. nurses) if the firstcaregiver does not exit the contamination zone within ten seconds of thecontrolled Handwashing Event and determines an Exposure Event hasoccurred for a second caregiver of a second class of caregivers (e.g.physicians) only if the second caregiver does not exit the contaminationzone within twenty seconds of the controlled Handwashing Event.

In an exemplary embodiment, the master station 129 determines that anInfraction Event has occurred when a caregiver 110 has committed aviolation of the handwashing standards. In the exemplary embodiment, themaster station 129 determines whether an Infraction Event has occurredbased upon information (e.g. caregiver location, handwashinginformation) received from the various sensors of the hygiene monitoringsystem 100. In an exemplary embodiment, the master station 129 utilizesthe following rules to determine whether an Infraction Event hasoccurred.

1) An Infraction Event occurs each time a caregiver 110 exits acontamination zone while “Contaminated”, and then does not successfullywash her hands within a Trigger Time of exiting the contamination zone.

2) An Infraction Event occurs each time a caregiver 110 while“Contaminated” enters a contamination zone, and then does notsuccessfully wash her hands within a Entry Time of entering thecontamination zone.

The exemplary embodiment defines the Trigger Time as the time for aparticular contamination zone that a contaminated caregiver 110 mayleave that particular contamination zone without successfully washingthe hands at a monitored handwashing device (i.e. cause a controlledHandwashing Event) and not generate an Infraction Event. The exemplaryembodiment further defines the Entry Time as the time for a particularcontamination zone that a contaminated caregiver 110 may remain in thatparticular contamination zone without successfully washing her hands ata monitored handwashing device (i.e. cause a controlled HandwashingEvent) and not generate an Infraction Event. Similar to the ExposureTime, the Trigger Time and the Entry Time of the exemplary embodimentare independently defined for each contamination zone of the facilityand are typically defined at a constant value for a particularcontamination zone. The Trigger Time and Entry Time, however, mayalternatively be defined based upon a particular caregiver or class ofcaregivers. For example, the Trigger Time for a particular contaminationzone may be defined such that the master station 129 determines that anInfraction Event has occurred for a first caregiver if the firstcaregiver does not successfully wash her hands (i.e. generate acontrolled Handwashing Event) within ten seconds of exiting thecontamination zone and cause an Infraction Event for a second caregiveronly if the second caregiver does not successfully wash her hands (i.e.generate a controlled Handwashing Event) within twenty seconds ofexiting the contamination zone.

The following scenario of events is provided in order to provide furtherinsight into how the second handwashing logic of FIG. 8 may be utilized.For example, in response to a caregiver entering the facility for thefirst time as a new shift begins, the exemplary hygiene monitoringsystem 100 would likely determine that either a preset period of timehas past since the caregiver was last detected (step 300) or woulddetermine that a preset period of time has past since the lastsuccessful handwashing was detected (step 302) and thus process anExposure Event (step 304). The hygiene monitoring system 100 inprocessing the Exposure Event generally updates information associatedwith the caregiver by storing the identification code (i.e. ID) of thecaregiver received from the caregiver's badge 112, storing the time thehygiene monitoring system 100 detected the Exposure Event, and updatingthe contamination status for the caregiver to “Contaminated”. Moreover,the hygiene monitoring system 100 in processing the Exposure Eventprovides the caregiver with an indication of the contamination statusassociated with the caregiver by, for example, causing the badge 112 toblink yellow.

In response to the badge 112 indicating that the caregiver iscontaminated, the caregiver may then stop at a sink 102 located in anon-contamination zone and successfully wash her hands, thus causing acontrolled Handwashing Event. Accordingly, the hygiene monitoring system100 detects the controlled Handwashing Event in the non-contaminationzone (step 330) and process the controlled Handwashing Event (step 332).In particular, the hygiene monitoring system 100 in processing thecontrolled Handwashing Event updates information associated with thecaregiver by recording the ID of the caregiver, recording the time thehygiene monitoring system 100 detected the controlled Handwashing Event,recording the ID of the sink 102 at which the caregiver washed herhands, updating a contamination status for the caregiver to “NotContaminated”, updating an infraction status for the caregiver to“Compliant”, and if the caregiver was contaminated prior to thecontrolled Handwashing Event updating the compliance rating for thecaregiver. By only updating the compliance rating if the caregiver wascontaminated, the hygiene monitoring system 100 prevents caregivers fromartificially inflating their compliance rating by performing unnecessaryhandwashings. Moreover, the hygiene monitoring system 100 in processingthe controlled Handwashing Event further provides the caregiver with anindication of her status by, for example, causing the badge 112 to stopblinking, causing the sink 102 to display a “Handwashing Confirmed”message, and causing the sink 102 to display the ID and currentcompliance rating for the caregiver.

The caregiver after successfully washing her hands may enter patientroom A and remain in patient room A for a period of time greater thanthe Exposure Time associated with patient room A, thus causing anExposure Event. Accordingly, the hygiene monitoring system 100 detectsthe Exposure Event (step 314) and processes the Exposure Event (step316). The hygiene monitoring system 100 in processing the Exposure Eventgenerally updates information associated with the caregiver by storingthe ID of the caregiver, storing the time the hygiene monitoring system100 detected the Exposure Event, storing the location at whichcontamination occurred, and updating the contamination status associatedwith the caregiver to “Contaminated”. Moreover, the hygiene monitoringsystem 100 in processing the Exposure Event provides the caregiver withan indication that her status is “Contaminated” by, for example, causingthe badge 112 to blink yellow.

The caregiver may then leave patient room A enter a hallway and traveldown the hallway for a period of time that is greater than the TriggerLimit for patient room A, thus causing an Infraction Event. The hygienemonitoring system 100 detects the Infraction Event (step 324) andprocesses the Infraction Event (326). The hygiene monitoring system 100in processing the Infraction Event generally updates informationassociated with the caregiver by storing the ID of the caregiver,storing the time the hygiene monitoring system 100 detected theInfraction Event, updating the infraction status of the caregiver to“Infraction Level 1”, storing information about the Infraction Event(e.g. did not wash hands within Trigger Time of leaving patient room A),and updating the compliance rating of the caregiver. Further, thehygiene monitoring system 100 provides the caregiver with an indicationthat her status is “Infraction Level 1” by, for example, causing thebadge 112 to slowly blink red.

The caregiver may then enter patient room B and remain in patient room Bfor a period of time greater than the Entry Limit associated withpatient room B without successfully washing her hands, thus causinganother Infraction Event. The hygiene monitoring system 100 detects thatthe caregiver was in a contamination zone (step 306), detects that thecaregiver was contaminated (step 308), detects the Infraction Event(step 310) and processes the Infraction Event (step 312). The hygienemonitoring system 100 in processing the Infraction Event generallyupdates information associated with the caregiver by storing the ID ofthe caregiver, storing the time the hygiene monitoring system 100detected the Infraction Event, updating the infraction status of thecaregiver to “Infraction Level 2”, storing information about theInfraction Event (e.g. did not wash hands within Entry Time of enteringpatient room B), and updating the compliance rating of the caregiver.Further, the hygiene monitoring system 100 provides the caregiver withan indication that her status is “Infraction Level 2” by, for example,causing the badge 112 to increase its rate of blinking red.

The caregiver may remain in patient room B for a period of time greaterthan the Exposure Time associated with patient room B, thus causing anExposure Event. Accordingly, the hygiene monitoring system 100 detectsthe Exposure Event (step 314) and processes the Exposure Event (step316). The hygiene monitoring system 100 in processing the Exposure Eventgenerally updates information associated with the caregiver by storingthe ID of the caregiver, storing the time the hygiene monitoring system100 detected the Exposure Event and storing the location at whichcontamination occurred. Since the caregiver's contamination status isalready “Contaminated” the hygiene monitoring system 100 need not updatethe contamination status to “Contaminated”. Moreover, the hygienemonitoring system 100 in processing the Exposure Event continues toprovide the caregiver with an indication that her status is “InfractionLevel 2” by, for example, continuing to cause the badge 112 to blink redat the increase rate.

The caregiver may then leave patient room B enter a hallway and traveldown the hallway for a period of time that is greater than the TriggerTime for patient room B, thus causing another Infraction Event. Thehygiene monitoring system 100 detects the Infraction Event (step 324)and process the Infraction Event (326). The hygiene monitoring system100 in processing the Infraction Event generally updates informationassociated with the caregiver by storing the ID of the caregiver,storing the time the hygiene monitoring system 100 detected theInfraction Event, updating the infraction status of the caregiver to“Infraction Level 3”, storing information about the Infraction Event(e.g. did not wash hands within Trigger Time of leaving patient room B),and updating the compliance rating of the caregiver. Further, thehygiene monitoring system 100 provides the caregiver with an indicationthat her status is “Infraction Level 3” by, for example, causing thebadge 112 to blink red at an even faster rate than is associated with“Infraction Level 2”.

The caregiver may then enter patient room C and remain in patient room Cfor a period of time greater than the Entry Time associated with patientroom C without successfully washing her hands, thus causing anotherInfraction Event. The hygiene monitoring system 100 detects theInfraction Event (step 310) and processes the Infraction Event (312).The hygiene monitoring system 100 in processing the Infraction Eventgenerally updates information associated with the caregiver by storingthe ID of the caregiver, storing the time the hygiene monitoring system100 detected the Infraction Event, updating the infraction status of thecaregiver to “Infraction Level 4”, storing information about theInfraction Event (e.g. did not wash hands within Entry Time of enteringpatient room C), and updating the compliance rating of the caregiver.Further, the hygiene monitoring system 100 provides the caregiver withan indication that her status is “Infraction Level 4” by, for example,causing the badge 112 to be continuously lit red, and causing an audiblealarm to be activated whenever the caregiver is in proximity of ahandwashing device 101.

In response to noticing the audible alarm and the badge 112 indicating“Infraction Level 4”, the caregiver may then stop at a sink 102 locatedin the patient room C, successfully wash her hands and exit patient roomC before the Exit Time has expired, thus causing a controlledHandwashing Event. Accordingly, the hygiene monitoring system 100detects the controlled Handwashing Event in patient room C (steps 318),processes the controlled Handwashing Event (step 320), and determinesthat the caregiver exited the patient room C before being recontaminated(step 322). In particular, the hygiene monitoring system 100 inprocessing the controlled Handwashing Event updates informationassociated with the caregiver by recording the ID of the caregiver,recording the time the hygiene monitoring system 100 detected thecontrolled Handwashing Event, recording the ID of the sink 102 at whichthe caregiver washed her hands, updating the contamination status forthe caregiver to “Not Contaminated”, updating the infraction status to“Compliant”, and if the caregiver was contaminated prior to thecontrolled Handwashing Event updating the compliance rating for thecaregiver. Moreover, the hygiene monitoring system 100 in processing thecontrolled Handwashing Event further provides the caregiver with anindication of her status by, for example, causing the badge 112 to nolonger light on LED causing the sink 102 to display a “HandwashingConfirmed” message, and causing the sink 102 to display the ID andcurrent compliance rating for the caregiver.

The caregiver may then enter a high risk contamination zone (e.g. anisolation room, waste utility room, public restroom) having an ExposureTime of zero, thus causing an Exposure Event. Accordingly, the hygienemonitoring system 100 detects the Exposure Event (step 314) and processthe Exposure Event (step 316). The hygiene monitoring system 100 inprocessing the Exposure Event generally updates information associatedwith the caregiver by storing the ID of the caregiver, storing the timethe hygiene monitoring system 100 detected the Exposure Event andstoring the location at which contamination occurred, and updating thecontamination status for the caregiver to “Contaminated”. Moreover, thehygiene monitoring system 100 in processing the Exposure Event continuesto provide the caregiver with an indication that her status is“Contaminated” by, for example, causing the badge 112 to blink yellow.

The caregiver may then exit the high risk contamination zone, re-enterpatient room A, and successfully wash her hands before the expiration ofthe Trigger Time associated with the high risk contamination zone andbefore the expiration of the Entry Time associated with patient room A.Accordingly, the hygiene monitoring system 100 detects the controlledHandwashing Event in patient room C (step 310 or step 324) and processesthe controlled Handwashing Event (step 312 or step 328). In particular,the hygiene monitoring system 100 in processing the controlledHandwashing Event updates information associated with the caregiver byrecording the ID of the caregiver, recording the time the hygienemonitoring system 100 detected the controlled Handwashing Event,recording the ID of the sink 102 at which the caregiver washed herhands, updating the contamination status for the caregiver to “NotContaminated”, updating the infraction status for the caregiver to“Compliant”, and if the caregiver was contaminated prior to thecontrolled Handwashing Event updating the compliance rating for thecaregiver. Moreover, the hygiene monitoring system 100 in processing thecontrolled Handwashing Event further provides the caregiver with anindication of her status by, for example, causing the badge 112 to nolonger light an LED, causing the sink 102 to display a “HandwashingConfirmed” message, and causing the sink 102 to display the ID andcurrent compliance rating for the caregiver.

Equipment Monitoring

The use of equipment badges 113 and usage sensors 119 on equipment 115generally allows the hygiene monitoring system 100 to more accuratelypinpoint when an event has occurred with a piece of equipment 115 thatrequires a handwashing. For example, if the hygiene monitoring system100 determines that (i) a caregiver 110 has entered a patient zone, (ii)the caregiver has remained in the zone for a given length of time, and(iii) the IV pump has been activated during the given length of time,then the hygiene monitoring system 100 can deduce with a high degree ofconfidence that the caregiver has set an IV line, thus requiring thecaregiver to wash her hands before entering the next contamination zone.Accordingly, the handwashing logic of FIG. 6 and the handwashing logicof FIG. 7 may be further modified such that the master station 129determines whether a caregiver 110 needs to wash her hands based upon acaregiver's likely usage of equipment 115.

Furthermore, the use of equipment badges 113 on equipment 115 enablesthe hygiene monitoring system 100 to monitor compliancy with hygienestandards defined for the equipment 115. In particular, much of thesupport equipment 115 within a patient room is electronic and requiresspecial handling when cleaning between patient. The standard practicewithin most hospitals is that housekeeping is not allowed to clean thesedevices and the responsibility of such cleaning falls upon the nurse.Since this support equipment 115 commonly comes into direct contact withvery sick patients with potentially transferable diseases, suchequipment 115 must be decontaminated (or cleaned) before used withanother patient.

Referring to FIG. 9, there is depicted a flowchart of exemplaryequipment decontamination logic utilized by the exemplary hygienemonitoring system 100. In general, the master station 129 executes theprocedure depicted in FIG. 9 whenever equipment 115 having an equipmentbadge 113 is moved from one location to another location or whenever anew patient is admitted to a patient room containing monitored equipment115.

As illustrated in FIG. 9, the master station 129 in step 402 determineswhether a piece of equipment 115 having an equipment badge 113 is in anew location. The master station 129 in the exemplary embodiment makesthis determination by processing location information for the equipment115 which the master station 129 has received via the equipment badge113 and the sensors 118 of the hygiene monitoring system 100. If thelocation information for the equipment 115 indicates that the currentlocation of the equipment 115 is the same as the last location for theequipment 115 (e.g. the current location and the last location of theequipment 115 are the same patient room), then the master station 129 instep 402 determines that the equipment 115 is not in a new location andproceeds to step 404 in order to determine whether a new patient is withthe equipment 115. However, if the location information for theequipment 115 indicates that the current location of the equipment 115is not the same as the last location of the equipment 115 (e.g. thecurrent location of equipment 115 is a first patient room and the lastlocation of the equipment 115 was a different patient room), then themaster station 129 proceeds to step 406 in order to determine whether anew patient is with the equipment 115.

In step 404, the master station 129 of the exemplary embodimentdetermines whether a new patient is with the equipment 115 by comparingpatient location information received via badges 112 with equipmentlocation information received via equipment badges 113. If the masterstation 129 determines based upon the patient location information andthe equipment information that a new patient is with the equipment 115(e.g. the equipment location information indicates the equipment 115 isin a first patient room and the patient location information indicatesthat a patient who has not previously been detected in the first patientroom in now in the first patient room), then the master station 129determines that a new patient is with the equipment 115 and proceeds tostep 410 to confirm whether the equipment 115 has been cleaned. On theother hand, if the master station 129 determines based upon the patientlocation information and the equipment information that a new patient isnot with the equipment 115 (e.g. the equipment location informationindicates the equipment 115 is in a first patient room and the patientlocation information indicates that the patient who is in the firstpatient has been previously detected in the patient room), then themaster station 129 determines that a new patient is not with theequipment 115 and stops execution of the equipment decontamination logicuntil the next triggering event.

Similarly, the master station 129 of the exemplary embodiment in step406 determines whether a new patient is with the equipment 115 bycomparing patient location information received via badges 112 withequipment location information received via equipment badges 113. If themaster station 129 determines based upon the patient locationinformation and the equipment information that a new patient is with theequipment 115 (e.g. the equipment location information and the patientlocation information indicate that the equipment 115 and the patienthave not previously been in the same patient room at the same time),then the master station 129 determines that a new patient is with theequipment 115 and proceeds to step 410 to confirm whether the equipment115 has been cleaned. On the other hand, if the master station 129determines based upon the patient location information and the equipmentinformation that a new patient is not with the equipment 115 (e.g. theequipment location information and the patient location informationindicate that the equipment 115 and the patient have previously been inthe same patient room at the same time), then the master station 129determines that a new patient is not with the equipment 115 and proceedsto step 408.

In step 408, the master station 129 determines whether the equipment 115needed to be cleaned due to exposure to a high risk contamination zonesuch as an isolation room or a waste utility room. To this end, themaster station 129 of the exemplary embodiment determines that theequipment 115 needed to be cleaned and proceeds to step 410 if equipmentlocation information for the equipment 115 indicates that the previouslocation of the equipment 115 was a high risk contamination zone.Otherwise, the master station 129 stops execution of the equipmentdecontamination logic until the next triggering event.

The master station 129 in step 410 determines whether the equipment 115has been successfully cleaned since the equipment 115 was last used byanother patient or was last exposed to a high risk contamination zone.To this end, the master station 129 determines based upon caregiver andpatient location information received from the badges 112, equipmentlocation information received from the equipment badges 113, andcleaning information received from the cleaning sensor 121 whether theequipment 115 has been successfully cleaned since last beingcontaminated. In particular, the master station 129 determines when theequipment 115 was last contaminated by the equipment's most recentexposure to either another patient or a high risk contamination zone byanalyzing received equipment location information and patient locationinformation. Further, the master station 129 determines whether theequipment 115 has been successfully cleaned since the equipment's lastexposure to either another patient or a high risk contamination zone byanalyzing cleaning information received from the associated cleaningsensor 121. In the exemplary embodiment, the master station 129 and/orthe cleaning sensor 121 enforces adequate cleaning of the equipment 115by requiring that (i) the person cleaning the equipment 115 be in closeproximity to the equipment 115 for at least a minimum cleaning period oftime, (ii) the cleaning sensor 121 detect moisture associated with thecleaning process for at least the minimum cleaning period of time,and/or (iii) the cleaning sensor 121 detect physical contact associatedwith the cleaning process for at least the minimum cleaning period oftime.

If the master station 129 in step 410 determines that the equipment 115has been successfully cleaned, then the master station 129 stopsexecution of the equipment decontamination logic until the nexttriggering event. However, if the master station 129 in step 410determines that the equipment 115 has not been successfully cleaned,then the master station 129 in step 412 activates a cleaning statusalarm associated with the equipment 115 and records the fact that thepatient has been exposed to a contaminated piece of equipment 115. As aresult of activating the cleaning status alarm, an indication isprovided that the equipment 115 needs to be cleaned. For example, lightson the equipment 115 itself and/or a status monitor for the patient roommay be illuminated. Also, sound may be emitted from the equipment 115and/or a status monitor for the patient room.

Similar to step 410, the master station 129 in step 414 determineswhether the equipment 115 has been successfully cleaned since theactivation of the cleaning status alarm. To this end, the master station129 determines based upon caregiver and patient location informationreceived from the badges 112, equipment location information receivedfrom the equipment badges 113, and cleaning information received fromthe cleaning sensor 121 whether the equipment 115 has been successfullycleaned. In particular, the master station 129 analyzes the informationreceived from badges 112, 113, and the associated cleaning sensor 121 inorder to determine whether (i) the person cleaning the equipment 115 hasbeen in close proximity to the equipment 115 for at least a minimumcleaning period of time, (ii) the cleaning sensor 121 has detectedmoisture associated with the cleaning process for at least the minimumcleaning period of time, and/or (iii) the cleaning sensor 121 hasdetected physical contact associated with the cleaning process for atleast the minimum cleaning period of time.

If the master station 129 in step 414 determines that the equipment 115has not been successfully cleaned, then the master station 129 returnsto step 412 to make another determination of whether the equipment 115has been successfully cleaned. If the master station 129 in step 414determines that the equipment 115 has been successfully cleaned, thenthe master station 129 in step 416 deactivates the cleaning status alarmwhich was activated in step 412 and records the fact that the equipment115 has been successfully cleaned.

The following scenario illustrates the operation of the hygienemonitoring system 100 in implementing the equipment decontaminationlogic of FIG. 9. To begin, a first patient who is wearing an IDwristband equipped with a badge 112 is admitted to a patient room.Later, a clean IV pump that is equipped with an equipment badge 113 andcleaning sensors 121 is brought into the patient room. As a result, themaster station 129 would determine that the equipment 115 has changedlocation (step 402) and a new patient is with the equipment 115 (step406). The master station 129 then would determine in step 410 that theequipment 115 has been cleaned since its last use or exposure to a highrisk contamination zone. Accordingly, the master station 129 would exitthe procedure without activating the cleaning status alarm.

After two days, the patient is transferred from his patient room in theintensive care unit (ICU) to another room of the surgery floor. The IVpump accompanies the patient during the transfer to the new room.Accordingly, the master station 129 would determine that the equipment115 has changed location (step 402) but that a new patient is not withthe equipment 115 (step 406). The master station 129 then woulddetermine in step 408 that the equipment 115 has been not beencontaminated due to exposure to a high risk contamination zone.Therefore, the master station 129 would exit the procedure withoutactivating the cleaning status alarm.

In another day, the first patient is discharged from the hospital andthe IV pump is returned to the ICU floor and placed into the originalpatient room with a new patient who is wearing an ID wristband equippedwith a badge 112. At this point, the master station 129 would determinethat the equipment 115 has changed location (step 402) and that a newpatient is with the equipment 115 (step 406). The master station 129then would determine in step 410 that the equipment 115 has been notbeen cleaned since being contaminated due to being exposed to thedischarged first patient. Accordingly, the master station 129 in step412 would activate the cleaning status alarm associated with the IV pumpand record the fact that the IV pump was not cleaned before being placedin the room with the new patient. The master station 129 would thencontinually monitor the IV pump until the cleaning sensors 121 indicatethat the IV pump has been properly cleaned (step 414). At which time,the master station 129 would deactivate the cleaning status alarmassociated with the IV pump and record the fact that the IV pump hasbeen properly cleaned (step 416).

Compliance Reports and System Interface

Shown in FIGS. 4, 10-12, 13A, 13B, and 14 are various examples ofdifferent compliance reports 128 that are generated by the hygienemonitoring system 100. While the exemplary compliance reports 128 onlydepict compliance information associated with handwashing, thecompliance reports 128 could easily be modified or new compliancereports created which depict compliance information associate withproper equipment cleaning practices. In one embodiment, hygienecompliance is analyzed using chi-squared analysis. In anotherembodiment, hygiene compliance compares handwashing events to employeemovement. In another embodiment, every Event that affects theContamination Status, Infraction Status, Compliance Rating, orMaintenance Status as well as every change in location for a badge 112,113 is reported to the master station 129. Such information is sent tothe master station 129 in the form of messages. Exemplary messages arepresented in Table 1.

TABLE 1 Message When Data Location Entry Transmitted when a badge isfirst seen Badge ID in a location. Sensor ID Timestamp Location ExitTransmitted when a badge is no longer Badge ID seen by a sensor. SensorID Timestamp Contamination Transmitted when a Badge ID's status Badge IDEvent changes from “not contaminated” to Sensor ID “contaminated”.Timestamp Infraction Event Transmitted each time an event Badge IDaffecting an individual's compliance Sensor ID rating occurs. TimestampInfraction Level Controlled Transmitted when a Controlled Badge IDHandwash Event Handwash Event has been completed. Sensor ID TimestampFailed Handwash Transmitted when a Failed Handwash Badge ID Event Eventhas occurred. Sensor ID Timestamp Maintenance Transmitted when thestatus bits of a Sensor ID Request Event particular faucet monitoringdevice Timestamp indicate that a Maintenance Activity Maintenance isrequired. Activity

FIG. 10 shows a hospital summary report. The hospital summary reportprovides a summary of compliance to handwashing guidelines for thehospital as a whole and specific departments within a healthcareenvironment. The purpose of the report is to identify departments withinthe hospital that have the most difficulty with compliance so thatcorrective action may be taken. As can be seen in FIG. 10, the reportprovides the time period that this report is associated with, an overallcompliance rating and a breakdown of compliance ratings based upondepartment. As shown in FIG. 10, department ICU had a 70 percentcompliance for a total number of 1500 visitations during the time periodof October 1999.

In FIG. 11, a department summary report is shown. The department summaryreport provides a summary of the compliance to handwashing guidelinesfor a specific department within a healthcare environment. The purposeof the report is to identify areas within the unit and groups ofcaregivers which have the most difficulty with compliance so thatcorrective action may be taken. As shown in FIG. 11, the departmentsummary report includes the department name and number, the time periodfor which the report is generated and an overall department compliancerating. The report also breaks the department down into differentlocations or zones. These are provided with a specific identificationnumber (e.g. location 201). This breakdown allows the person viewing thereport to determine which zones are having the most difficulty withhandwashing compliance. Also shown in FIG. 11, is the compliance foreach zone along with the number of visitations to that zone during aspecific time period. The department summary report also provides abreakdown for the groups within the report showing the individual groupscompliance ratings. This breakdown allows quick identification of thecontribution made by each group to the overall compliance rating.

FIG. 12 illustrates an example of a group summary report. The groupsummary report provides a summary of the compliance to handwashingguidelines for a specific group of caregivers within the healthcareenvironment. The purpose of the report is to identify areas within theunit where the compliance is low so that corrective action may be takenwithin a specific group of caregivers. As can be seen from FIG. 12, thevisiting physician group summary report contains the department name andnumber, the time period of the report and the overall compliance ratingof the report. The report breaks the department down into differentlocations or zones. This breakdown allows the person reviewing thereport to determine which zones are having the most difficulty withhandwashing compliance. The report also breaks down the group into theindividuals within the group showing their identification number, name,number of visitations and the individual compliance. This allowsidentification of the contribution of each individual to the overallcompliance rating of the group.

FIG. 13A shows an individual summary report. The individual summaryreport provides a summary of the compliance to handwashing guidelinesfor a specific individual within a healthcare environment. The purposeof the report is to identify areas within the unit wherein an individualis having the most difficulty with compliance so that corrective actionmay be taken. As shown in FIG. 13A, the individual summary reportincludes the identification number of the person, the name of theperson, the department and group to which the person belongs, the timeperiod for the report, and the compliance rating for the department.Also provided are the different locations or zones within the departmentwith the number of visitations the particular individual made to thosezones, and the individual's compliance rating during those visits.

FIG. 13B shows a detailed compliance report for an individual. Thedetailed compliance report provides a summary of the compliance tohandwashing guidelines for a specific individual over a specific timeperiod within the healthcare environment. The purpose of the report isto understand traffic patterns of the individual so that greater insightas to why compliance is not occurring may be gained. As shown in FIG.13B, the identification number of the individual, the name of theindividual, the department and group to which the individual belongs,the time period for which the report is being generated, and thecompliance rating for the individual are shown. The lower portion of thereport breaks down the locations or zones the individual visited alongwith the times of the visits and the status that was recorded by thehandwashing monitoring logic.

FIG. 14 shows an exemplary user interface 500 of the hygiene monitoringsystem 100. In the exemplary embodiment, the user interface wasimplemented as a MedModel application executing on the master station129. As is known to those skilled in the art, MedModel is a softwaretool of ProModel Corporation which is generally used for simulationmodeling of healthcare facilities. As depicted, the user interface 500generally includes a floor layout 502 and a scoreboard status 505. Thefloor layout 502 generally depicts the zones and rooms 504 of thefacility as well as handwashing devices 506, equipment 508, and persons510. In the exemplary embodiment, the zones and rooms 504 are colorcoded in order to enable a user to quickly identify the classificationof the zones and the room 504. Moreover, the handwashing devices 506 aredepicted such that they blink if there is a problem associated with thehandwashing device (e.g. out of soap). Moreover, equipment 508 andpersons 510 are also color coded in order to depict their current status(e.g. contaminated, or not contaminated).

The scoreboard status 504 generally provides pseudo-realtime statisticsand other information for the facility. For example, as depicted in FIG.14, the scoreboard status 504 may provide a display of runningcompliance rates in regard to a defined handwashing policy for thefacility. In particular, the scoreboard status 504 may be set to displayoverall and unit compliance ratings and contribution of sanitizer andhandwashing events over the past hour, day, month and year.

The user interface 500 also enables a user to view or modify statusdetails based upon a clearance level associated with the particularuser. In the exemplary embodiment, a user may have a first clearancelevel, a second clearance level, or a third clearance level associatedtherewith. If a first clearance level is associated with the user, thenthe exemplary user interface 500 enables a user to select a given room505 in order to view the classification of the room, status of sensorsin the room, and overall compliance associated with the room. A userhaving a second clearance level may do all of the above with respect torooms 505 plus the user may respond to maintenance alarms and changeroom classifications via the user interface 500. Further, a user havinga third clearance level may do all of the above with respect to rooms505 plus the user may reconfigure room layout and sink locations,reassign sensor classifications (e.g. associated with or not associatedwith a handwashing device), change color layout, view managerial reportssuch as running compliance rates and employee compliance rates.

If a user has the first clearance level, then that user may also selecta sink 506 in order to obtain system status information for the sink,obtain a graphic display of soap level and scrub duration setting,obtain a graphic display of the unit use profile for the past day, monthor year compared to the average and overall use of all other sinks,obtain information comparing completed versus failed controlledhandwashing events for the sink, and obtain a graphical display ofmechanical performance rating for the sink. If a user has the second orthird clearance level, then that user may perform all of the aboveactions in regard to sinks 506 plus the user may respond to maintenancealarms associated with the sinks.

If a user has the first clearance level, then that user may also selecta hand sanitizer 506 in order to obtain system status information forthe hand sanitizer, obtain a graphic display of sanitizer level andscrub duration setting, obtain a graphic display of the unit use profilefor the past day, month or year compared to the average and overall useof all other sinks, and obtain information comparing completed versusfailed controlled handwashing events for the hand sanitizer, and obtaina graphical display of mechanical performance rating for the handsanitizer. If a user has the second or third clearance level, then thatuser may perform all of the above actions in regard to hand sanitizers506 plus the user may respond to maintenance alarms associated with thehand sanitizers.

If a user has the third clearance level, then that user may furtherselect a person 510 to display the ID number of individual, obtain agraphical display of the individuals compliance and the individualscontribution of sanitizer and handwashing events for the past day, monthor year compared to average and overall compliance rating, obtaindistribution of infraction levels for the individual, and obtain anemployee profile for the individual including name, number, title, unitetc.

If a user has the first clearance level, then that user may furtherselect equipment 508 to display a description of the equipment, displaythe current status of the equipment, obtain a graphic display of thecleaning profile for the past day, month or year compared to average andoverall cleaning of all other devices, and obtain a graphical display onoverall compliance to cleaning for the equipment. If a user has thesecond clearance level, then that user may perform all of the above inregard to equipment 508 plus the user may respond to maintenance alarmsassociated with the equipment. If a user has the third clearance level,then that user may perform all of the above in regard to equipment 508plus the user may reclassify the ID associated with the equipment.

It is within the scope of the present invention for the same overallsystem to be used for a multitude of applications. As already stated thesystem can be used to monitor handwashing compliance, monitoring deviceactivity, equipment tracking, and visitor tracking. By utilizing thesame backbone infrastructure the cost for the entire system is able tobe spread across a multitude of applications. Additionally the cost ofadding additional modules such as visitor tracking is minimal becausethe backbone infrastructure is already in place.

1-20. (canceled)
 21. A system comprising locating and tracking equipmentto track the whereabouts of caregivers in a healthcare facility, thelocating and tracking equipment including a plurality of badges, eachbadge being transported by an associated caregiver in the healthcarefacility, each badge being operable to transmit badge information, aplurality of handwashing equipment sensors, each handwashing equipmentsensor of the plurality of handwashing equipment sensors beingassociated with respective handwashing equipment, each handwashingequipment sensor being operable to transmit handwashing information, andat least one remote computer device configured to receive the badgeinformation and the handwashing information, the at least one remotecomputer device operating to determine compliance with a handwashingprotocol of the healthcare facility based on the badge information andthe handwashing information, the at least one remote computer devicealso receiving from the handwashing equipment data regarding amaintenance status of the handwashing equipment.
 22. The system of claim21, wherein the data regarding maintenance status of the handwashingequipment indicates whether a hand washing agents container is low. 23.The system of claim 21, wherein the data regarding maintenance status ofthe handwashing equipment indicates whether a hand washing agentscassette needs to be changed.
 24. The system of claim 21, wherein thedata regarding maintenance status of the handwashing equipment indicateswhether a hand washing agents path needs to be changed.
 25. The systemof claim 21, wherein the data regarding maintenance status of thehandwashing equipment indicates whether a towel container is low. 26.The system of claim 21, wherein the data regarding maintenance status ofthe handwashing equipment relates to a faucet.
 27. The system of claim21, wherein the data regarding maintenance status of the handwashingequipment relates to a hand washing agents dispenser.
 28. The system ofclaim 21, wherein the handwashing protocol comprises caregivers washingtheir hands within a threshold amount of time after the locating andtracking equipment detects presence of the caregiver in a patient room.29. The system of claim 21, wherein the handwashing protocol comprisescaregivers washing their hands within a threshold amount of time afterthe locating and tracking equipment detects that the caregiver hasexited the patient room.
 30. The system of claim 21, wherein each badgeincludes a first receiver to receive wireless signals.
 31. The system ofclaim 30, wherein the first receiver receives wireless signals of a typedifferent than those that are transmitted by the badge.
 32. The systemof claim 21, wherein each badge transmits radio frequency (RF) signalsand/or infrared (IR) signals.
 33. The system of claim 21, wherein thehandwashing equipment comprises one or more handwashing agentsdispensers.
 34. The system of claim 21, further comprising a pluralityof alert indicators that remind associated caregivers to wash theirhands.
 35. The system of claim 34, wherein each alert indicator of theplurality of alert indicators is incorporated into a respective badge ofthe plurality of badges.
 36. The system of claim 34, wherein each alertindicator is located in a respective room of a plurality of patientrooms.
 37. The system of claim 34, wherein each alert indicator of theplurality of alert indicators is signaled by the at least one remotecomputer device to activate when a handwashing condition exists for theassociated caregiver.
 38. The system of claim 34, wherein the pluralityof alert indicators comprise lights.
 39. The system of claim 34, whereinthe plurality of alert indicators comprise audible indicators.
 40. Thesystem of claim 34, wherein the plurality of alert indicators comprisetactile indicators.
 41. The system of claim 21, wherein the locating andtracking equipment includes a plurality of infrared communication units,each infrared communication unit being located in a respective patientroom of the healthcare facility, each infrared communication unit beingassociated with the respective patient room in a database of the atleast one remote computer device, and each infrared communication unitcommunicating wirelessly with each of the plurality of badges that arelocated in the associated patient room.